Screening for Anal Cancer in Women With a History of Vulvar High-Grade Squamous Intraepithelial Lesions.
J Low Genit Tract Dis
; 23(4): 265-271, 2019 Oct.
Article
en En
| MEDLINE
| ID: mdl-31592974
ABSTRACT
OBJECTIVES:
The primary obkective was to determine the prevalence of (a) a positive anal cancer screen and (b) histological anal high-grade squamous intraepithelial lesion (HSIL) in women undergoing surveillance for previously diagnosed and treated human papillomavirus (HPV)-associated vulvar HSIL. The secondary objective was to determine the patients' acceptability of the screen. MATERIALS ANDMETHODS:
This is a single-institution, cross-sectional pilot study. Women, aged 30 to 80 years, with a history of biopsy-proven vulvar HSIL were invited to undergo screening for anal cancer. Positive screen characterized by abnormalities in any of the following anal high-risk HPV (HR-HPV); anal cytology; and digital anorectal examination. All women with an abnormal screen were referred for high-resolution anoscopy. All women completed a postscreen questionnaire.RESULTS:
Fifty-seven patients were recruited. The median (interquartile range) age was 61.5 (51.0-68.0) years. The prevalence of a positive screen was 56.1% (95% CI = 43.3%-68.2%). Of the 32 screen-positive patients, 12 had both abnormal cytology and HR-HPV, 3 had positive HR-HPV alone, and 17 had abnormal cytology alone. Of the 29 patients with a positive screen who went on to anoscopy, the prevalence of anal HSIL was 33.3% (95% CI = 19.2%-51.2%). The prevalence of anal HSIL among all of those who had screening (N = 57) was 18.2% (95% CI = 10.2%-30.3%). The examination was well tolerated with 100% of patients, indicating that they would have the screening again.CONCLUSIONS:
Women with vulvar HSIL have an increased risk of developing anal HSIL. Larger studies are needed to define optimal screening protocols as well as algorithms for management in high-risk populations.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias del Ano
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Neoplasias de la Vulva
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Detección Precoz del Cáncer
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Lesiones Intraepiteliales Escamosas
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Guideline
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Observational_studies
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Prevalence_studies
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Risk_factors_studies
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Screening_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
J Low Genit Tract Dis
Asunto de la revista:
GINECOLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Canadá